A coalition of women's and religious groups is urging Maryland state regulators to reject a proposal by Holy Cross Hospital to build a new hospital in Montgomery County because Catholic restrictions on reproductive health services could jeopardize access and care for low-income women and teens.

The Maryland Health Care Commission is scheduled to make a final decision Thursday on competing proposals from Silver Spring-based Holy Cross and Rockville-based Adventist HealthCare, capping more than two years of intense and costly competition.

At a news conference Wednesday and in a letter sent last week to the state commission, the Montgomery County Complete Care Coalition said that choosing Holy Cross would set a bad precedent by allowing a hospital with religiously mandated service restrictions to be built on land that is publicly owned. Holy Cross proposes to build a facility on the campus of Montgomery College in Germantown; Adventist's proposal is for a hospital a few miles to the north, in Clarksburg.

"We are gravely concerned that approval of the Holy Cross proposal by the Commission on January 20th could significantly undermine progress in addressing the public health priorities of Montgomery County and the state of Maryland, and could worsen already severe racial and ethnic health disparities," the coalition wrote in its letter.

Formed last year, the coalition includes Maryland NOW, NARAL Pro-Choice Maryland, Catholics for Choice, and Americans United for Separation of Church and State. It supports the Adventist proposal.

At least one of the groups, Americans United, said it is weighing legal options if the commission adopts an earlier reviewer's recommendation for Holy Cross.

Last month, commission chair Marilyn Moon said Holy Cross had the superior proposal, citing its track record in quality of care and other criteria, and noting that its parent organization, Trinity Health, a Catholic hospital system, was financially well positioned.

While acknowledging concerns about religious directives that prevent Catholic hospitals from providing some services, such as fertility treatments, abortions, tubal ligations and hormonal contraception, she concluded that Montgomery County was not an area "that lacks available and accessible options for obtaining these services."

Marissa Valeri, senior associate for domestic programs at Catholics for Choice, said Moon's recommendation "ignores the reality that for poor women, this will not be an option" to seek services elsewhere. A report issued last year about reproductive health in the county said only one-third of women in need of publicly supported reproductive health care are currently receiving it.

"Not all women know they can't get these services at Catholic hospitals until it's too late," said Melissa Kleder, interim director of NARAL Pro-Choice Maryland. "In emergency situations, time is of the essence," and many low-income women do not have access to a car, she said.

"Women will die if this goes through," said Linda Mahoney, president of Maryland NOW, referring to a vote for Holy Cross.

If the commission approves the Holy Cross proposal, the coalition is asking the state to require that Holy Cross provide emergency reproductive health care and prompt, medically appropriate treatment of emergency pregnancy conditions, such as ectopic pregnancies, premature rupture of membranes and life-threatening complications.

A spokeswoman for Holy Cross said it provides emergency contraception for patients who are victims of sexual assault. She said the "largest access problem in the county by far" has to do with prenatal and primary care services for uninsured women, and that Holy Cross is the largest provider of care to uninsured pregnant women.